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Screening autonomic function tests indicated orthostatic hypotension and confirmed chronic autonomic failure in 31(4.8%) patients. Neurally mediated syncope was diagnosed in 279 (43.5%) on the basis of clinical features and autonomic testin g. Most had vasovagal syncope (227 [35%]); other causes included carotid sinus hypersensitivity (37 [5.8%]), and a group of 15 (2.3%) were associated with rare causes such as micturition and swallowing. Miscellaneous cardiovascular causes (systemic hypo tension, arrhythmias), or drugs, contributed to syncope in 53 (8.3%). Non-autonomic neurological causes included vestibular dysfunction (32 [5%] and epilepsy (11 [1.7%]). In 56 (8.7%) a psychiatric cause was thought to be contributory. In 179 (27.9%), syncope was of unknown cause. In recurrent syncope and presyncope, when cardiac, neurological, and metabolic causes have been excluded, autonomic investigation can aid management by making, confirming, or excluding various factors or diagnoses. |
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autonomic dysfunction
orthostatic hypotension
syncope
syncope,differential diagnosis of
syncope,recurrent
syncope,work up for
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